Provider Demographics
NPI:1750917407
Name:BLACKSHAW, LAUREN DEASY (MA, NCC, LCMHC)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:DEASY
Last Name:BLACKSHAW
Suffix:
Gender:F
Credentials:MA, NCC, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13110 CINNAMON FERN LN
Mailing Address - Street 2:
Mailing Address - City:MINT HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28227-5691
Mailing Address - Country:US
Mailing Address - Phone:412-609-6537
Mailing Address - Fax:
Practice Address - Street 1:7319 MATTHEWS MINT HILL RD STE K
Practice Address - Street 2:
Practice Address - City:MINT HILL
Practice Address - State:NC
Practice Address - Zip Code:28227-7866
Practice Address - Country:US
Practice Address - Phone:412-609-6537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-13
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA13604101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health